Canada WorkSafe BC 57W1 2015 free printable template

Worker Complaint of Discriminatory Action RESET You are making a complaint of discriminatory action under Division 6 of the British Columbia Workers Compensation Act (the Act). Please use this form

How to fill out Canada WorkSafe BC 57W1

How to fill out Canada WorkSafe BC 57W1

1. Gather all necessary information related to the injury or incident.
2. Complete the worker's information section, including name, address, and contact details.
3. Provide details about the incident, including the date, time, and location.
4. Describe the nature of the injury or illness sustained by the worker.
5. Fill in the employer's information, including name and business details.
6. Include any witness information if available.
7. Ensure the form is signed and dated by the worker.
8. Submit the completed form to Canada WorkSafe BC within the required time frame.

Who needs Canada WorkSafe BC 57W1?

1. Any worker in British Columbia who has sustained an injury or illness related to their job.
2. Employers must also complete and submit this form on behalf of their injured workers.
3. Health care providers may need this form to provide proper care for injured workers.

Instructions and Help about Canada WorkSafe BC 57W1

To walk into this building was to walk into danger Undergoing renovation the building was riddled with unguarded floor openings A carpenter would fall 29 feet through one of them and be seriously injured Ladders were used to gain access to the upper floors None of the ladders were secured for stability But worse they shouldn't have been used for access Instead a stairway should have been built to access each level as it was constructed Firm A who owned the four-story building and was the prime contractor hired a general contractor to do the renovation The general contractor secured the sub-tradesand also employed workers including the carpenter and an apprentice a young worker On the day of the incident the carpenter and apprentice had been building a pony wall like this one inside the attic The general contractor wasn't on site However the principal of Firm A was While on the fourth floor he said to the apprentice It's a long way down there The principal left and the workers carried on with their work Holding a nail gun the carpenter stood Conan 8-foot stepladder next to the opening The ladder began to shake The carpenter fell landing on the floor then falling through the opening down to the second floor The apprentice immediately climbed down bladder to the second floor The carpenter lay on the floor seriously injured The apprentice called 9-1-1 The first responders arrived, but the lack of stairs complicated and delayed the rescue Eventually the carpenter was transported to hospital by ambulance The investigation found that1 The floor opening wasn't covered or guarded to prevent falls from elevation Floor and roof openings through which worker scan fall must be securely covered or be guarded by guardrails Consider covers first as they eliminate the hazard Covers should be of adequate size and strength nailed down or otherwise secured and well-marked Guardrails can be a second choice They must be 40 to 44 inches above the work surface and include a midrail If you're on stilts or a work platform you need to make the guardrails higher or use a personal fall protection system If it's not practicable to have a cover or guardrails you must use a personal fall protection system when working near the opening 2 A fall protection system wasn't used despite there being a fall hazard of about 21 feet You must use a fall protection system when work is being done where a fall of 10 feet or more may occur 3 The choice of equipment was inappropriate The ladder was too short for the task Ashe carpenters in order to reach up to the attic stood on the top step or cap If work can't be done from a ladder without danger to the worker a work platform such as a scaffold must be provided 4 The supervision was inadequate The general contractor allowed the workers to work in the area while being exposed to a fall hazard Supervise workers to ensure their health and safety The prime contractor was responsible for coordinating and maintaining health and safety at the site...

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What is Canada WorkSafe BC 57W1?

Canada WorkSafe BC 57W1 is a form used to report workplace injuries and incidents to ensure compliance with safety regulations and facilitate workers' compensation claims.

Who is required to file Canada WorkSafe BC 57W1?

Employers are required to file Canada WorkSafe BC 57W1 when a worker is injured on the job or there is a risk of injury that needs to be reported to WorkSafeBC.

How to fill out Canada WorkSafe BC 57W1?

To fill out Canada WorkSafe BC 57W1, provide detailed information about the worker, the incident, any witnesses, and actions taken. Ensure all required sections are completed and submit the form to WorkSafeBC.

What is the purpose of Canada WorkSafe BC 57W1?

The purpose of Canada WorkSafe BC 57W1 is to document workplace incidents, facilitate the processing of compensation claims, and help improve occupational health and safety measures.

What information must be reported on Canada WorkSafe BC 57W1?

The information that must be reported on Canada WorkSafe BC 57W1 includes the worker's details, description of the incident, nature of the injury, date and time of the incident, witnesses, and any immediate corrective actions taken.